Individual
SAMANTHA RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4511 BEDFORD AVE, BROOKLYN, NY 11235-2524
(646) 247-2649
Mailing address
4511 BEDFORD AVE, BROOKLYN, NY 11235-2524
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Enumeration date
07/09/2026
Last updated
07/09/2026
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